Abstract 4144763: Impact of Anemia on Clinical Outcomes in Atrial Fibrillation Patients on Oral Anticoagulants: A Systematic Review and Meta-analysis.

Abstract

Background: Anemia is frequently observed as a comorbidity in atrial fibrillation (AF) and is associated with poor clinical outcomes. Purpose: We aim to investigate the impact of anemia on clinical outcomes in AF Patients on oral anticoagulants. Methods: We comprehensively searched PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through March 2024 and conducted a prognostic systematic review and meta-analysis. All analyses were performed using R V. 4.3.1. Results: With the inclusion of 23 studies, our cohort comprised a total of 286,781 patients. Anemia was significantly associated with an 86% increase in the risk of major bleeding (HR: 1.86 with 95% CI [1.61, 2.14], P< 0.01), a 25% increase in the risk of intracranial hemorrhage (HR: 1.25 with 95% CI [1.02, 1.54], P= 0.03), a 92% increase in the risk of gastrointestinal bleeding (HR: 1.92 with 95% CI [1.68, 2.19], P< 0.01), and a 91% increase in the risk of all-cause mortality (HR: 1.91 with 95% CI [1.46, 2.51], P< 0.01). However, Anemia did not significantly affect the risk of stroke, TIA, or systemic embolism (HR: 1.07 with 95% CI [0.93, 1.22], P= 0.36). Conclusion: Anemia was significantly associated with an increased risk of major bleeding, intracerebral hemorrhage, gastrointestinal bleeding, and all-cause mortality without impacting stroke, TIA, or systemic embolism. Further research is warranted to compare the effects of DOACs and vitamin K antagonists. Clinically, it is imperative to closely monitor the anemic status of patients due to these elevated risks.